Oliver Sacks, writing on mania and manic depressive disorder in the New York Review of Books:

One may call it mania, madness, or psychosis–a chemical imbalance in the brain–but it presents itself as energy of a primordial sort. Greenberg likens it to “being in the presence of a rare force of nature, such as a great blizzard or flood: destructive, but in its way astounding too.” Such unbridled energy can resemble that of creativity or inspiration or genius–this, indeed, is what Sally feels is rushing through her–not an illness, but the apotheosis of health, the release of a deep, previously suppressed self.

These are the paradoxes that surround what Hughlings Jackson, the nineteenth-century neurologist, called “super-positive” states: they betoken disorder, imbalance in the nervous system, but their energy, their euphoria, makes them feel like supreme health. Some patients may achieve a startled insight into this, as did one patient of mine, a very old lady with neurosyphilis. Becoming more and more vivacious in her early nineties, she said to herself, “You’re feeling too well, you must be ill.” George Eliot, similarly, spoke of herself as feeling “dangerously well” before the onset of her migraine attacks.

I would love for Sacks to create a commonplace book, featuring all those quotes that he so effortlessly places throughout his prose. (Auden wrote a great one.) Speaking of manic depression, I’ve always been intrigued by Virginia Woolf’s bi-polar/manic-depressive disorder, as she typically experienced a burst of creativity after suffering a bout of depressive symptoms. To the Lighthouse, for instance, was written in a short burst of inspiration after a particularly punishing summer of illness. (Woolf would later joke that writing that novel was the closest she would ever come to undergoing psychoanalysis.)

Regarding mania and bipolar, I would point out that a manic episode is not just a burst of energy or creativity – the lack of impulse control and overwhelming energy can in fact be extremely dangerous for patients and those around them. At its absolute best, mania can be a productive state that enables thought processes which could not otherwise be accessed. Yet the worst of mania can be far, far worse than depression. Mania is often simplified as the reverse of depression (the anti-sad or anti-unproductive), but the symptoms and development of mania are so much more complicated than that. Mania can in fact be an extremely frightening experience for the patient — so called “mixed mania” is a particularly upsetting example of why bipolar is a debilitating and terrifying disorder.

Mania, in this sense, is a mind-altering event that is similar to getting high. My experience of observing many manic episodes in a close family members makes me think of mania as a high gone terribly, terribly wrong. The manic episodes I observed in one person (by no means representative) were never productive.